187 - Transition Readiness, Education and Knowledge (TREK) in Adolescent Medicine

Poster Number: 187
Publication Number: 187.142

Courtney Batt, University of Colorado School of Medicine, Aurora, CO, United States; Catherine Clark, Children's Hospital Colorado, Denver, CO, United States; Amanda R. Bogart, Medical/Healthcare, Aurora, CO, United States; Jennifer L. Woods, Children's Hospital Colorado, Aurora, CO, United States

Background: Adolescents and young adults (AYA) represent approximately one-third of outpatient pediatric visits, but often management includes little foresight into future adult care. Studies have shown that only 17% of AYA with special health care needs (SHCN) and 14% of AYA without SHCN met the transition of care measures needed to successfully continue healthcare services into adulthood. Evidence demonstrates that failure to provide adequate transition leads to negative health outcomes, and conversely, providing good transition leads to positive health outcomes. Most studies on transition have been conducted in subspecialty or disease specific settings.

Objective: Using a combination of provider assessment questionnaires and the Transition Readiness Assessment Questionnaire (TRAQ), we assessed provider and patient comfort with tasks involved in the transition from pediatric to adult providers.

Design/Methods: Adolescent medicine providers’ (n=11) knowledge and attitudes regarding transition from pediatric to adult providers were assessed using an anonymous 20-item questionnaire. Patient comfort with transition-related tasks was assessed via administration of TRAQ, a validated, 20 item patient-centered questionnaire.

Results: Adolescent medicine providers demonstrated heterogeneity in knowledge and comfort regarding transition. There was wide variability in the age at which transition is initially discussed (figure 1a) with less than half of providers indicating that they begin this discussion between 12-14 years old. In addition, providers expressed variable levels of comfort with discussing transition (figure 1b). Finally, many barriers were reported with the most common ones being time, lack of clinics to which to transition patients and knowledge about the process (figure 1c).

AYA demonstrate significant heterogeneity in their comfort level with transition-related tasks. 65%(220/339) report that they do not consistently fill a prescription when they need to (figure 2a), 63%(199/316) do not consistently attend part of their visit alone (figure 2b) and 55%(173/314) do not consistently contact their provider with health-related concerns (figure 2c).Conclusion(s): Given lack of consistent provider and patient knowledge and comfort with transition-related processes and tasks, additional interventions are needed for both providers and patients to aid in the process of pediatric to adult transition. Future research will focus on these measures after implementation of didactic sessions for providers and targeted interventions for AYA regarding transition.
Figure 1Select responses from provider survey regarding transition
Figure 2Select patient responses from TRAQ Questionnaire